This project was undertaken to assess academic emergency physicians' awareness of emergency department charges for routine care. A 60-item worksheet requiring estimates of patient charges for selected emergency department services, supplies, medications, and composite scenarios was used. The study was conducted at a university-affiliated academic emergency department and included 20 emergency medicine attendings and 20 emergency medicine residents. The questionnaires were distributed to the participants, independently completed, and immediately returned without discussion or consultation. All 40 surveys were analyzed. Answers were scored correct if the estimate was no more than 20% above or below the actual charge. The attending physicians scored an average of 19% of the items correctly, and the residents scored an average of 18% correctly. The average absolute error for attendings and residents were 89% and 105%, respectively. The proportion of those overestimating and underestimating each category were virtually identical in the 2 groups. We conclude from this study that emergency medicine attending physicians and residents do not have a good appreciation of patient charges for routine emergency care.